The UNLV American Indian Research and Education Center propose a community-based, participatory, translational research study entitled "Life in BALANCE" (Balancing Actions, Lifestyle, Autonomy, Nutrition, Community, &Environment). This two-year planning project will be a prelude to a large-scale, multi-site, cohort study of effective diabetes prevention among urban (nonreservation) American Indians/Alaska Natives. Research is needed to fully understand behavioral intervention, barriers to health care, cost effective diabetes prevention, education, and self-management and the social, cultural, and political mechanisms that create disparities in this underserved population. The study will apply the Diabetes Prevention Program (DPP) intensive "lifestyle coaching" clinical research intervention with the goal of improving modifiable risk factors, to ultimately achieve good glucose control, and prevent diabetes complications. American Indians/Alaska Natives living in urban settings are at high risk for diabetes and its complications but have not benefited from the body of research conducted in tribal communities. Planning for a project of this scope will include: 1) establishment of a strong community-based research infrastructure to guide development of translational research and a large scale clinical trial;and 2) conduct a pilot study with the urban Indian population in Southern Nevada. This study will provide knowledge and information regarding strategies for diabetes prevention and provide a foundation for future research. PUBLIC HEALTH RELEVANCE: This project is highly relevant to public health. Type 2 diabetes accounts for about 90- 95% of all diagnosed cases of diabetes (NDEP) and AI/AN on average are 2.2 times more likely to have diabetes as non-Hispanics whites. While diabetes care and prevention has been advanced in reservation-based populations, little is known about effective strategies for urban Indians, who constitute an estimate 60% of the total AI/AN population in the US.